Can they stomach it? Parent and practitioner acceptability of a trial comparing gastric residual volume measurement versus no gastric residual volume in UK NNU and PICUs: a feasibility study
Can they stomach it? Parent and practitioner acceptability of a trial comparing gastric residual volume measurement versus no gastric residual volume in UK NNU and PICUs: a feasibility study
Background: routine measurement of gastric residual volume (GRV) to guide feeding in neonatal and paediatric intensive care is widespread. However, this practice is not evidence based and may cause harm. As part of a feasibility study, we explored parent and practitioner views on the acceptability of a trial comparing GRV measurement or no GRV measurement.
Methods: a mixed-methods study involving interviews and focus groups with practitioners and interviews with parents with experience of tube feeding in neonatal and/or paediatric intensive care. A voting system recorded closed question responses during practitioner data collection, enabling the collection of quantitative and qualitative data. Data were analysed using thematic analysis and descriptive statistics.
Results: we interviewed 31 parents and nine practitioners and ran five practitioner focus groups (n=42). Participants described how the research question was logical, and the intervention would not be invasive and potential benefits of not withholding the child’s feeds. However, both groups held concerns about the potential risk of not measuring GRV, including delayed diagnosis of infection and gut problems, increased risk of vomiting into lungs and causing discomfort or pain. Parent’s views on GRV measurement and consent decision making were influenced by their views on the importance of feeding in the ICU, their child’s prognosis and associated comorbidities or complications.
Conclusions: the majority of parents and practitioners viewed the proposed trial as acceptable. Potential concerns and preferences were identified that will need careful consideration to inform the development of the proposed trial protocol and staff training.
Acceptability, Feasibility, Gastric residual volume, Intensive care
Deja, Elizabeth
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Roper, Louise
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Tume, Lyvonne N.
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Dorling, Jon
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Gale, Chris
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Arch, Barbara
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Latten, Lynne
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Pathan, Nazima
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Eccleson, Helen
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Hickey, Helen
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Preston, Jenny
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Beissel, Anne
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Andrzejewska, Izabela
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Valla, Frédéric V.
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Woolfall, Kerry
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Deja, Elizabeth
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Roper, Louise
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Tume, Lyvonne N.
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Dorling, Jon
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Gale, Chris
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Arch, Barbara
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Latten, Lynne
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Pathan, Nazima
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Eccleson, Helen
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Hickey, Helen
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Preston, Jenny
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Beissel, Anne
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Andrzejewska, Izabela
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Valla, Frédéric V.
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Woolfall, Kerry
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Deja, Elizabeth, Roper, Louise, Tume, Lyvonne N., Dorling, Jon, Gale, Chris, Arch, Barbara, Latten, Lynne, Pathan, Nazima, Eccleson, Helen, Hickey, Helen, Preston, Jenny, Beissel, Anne, Andrzejewska, Izabela, Valla, Frédéric V. and Woolfall, Kerry
(2021)
Can they stomach it? Parent and practitioner acceptability of a trial comparing gastric residual volume measurement versus no gastric residual volume in UK NNU and PICUs: a feasibility study.
Pilot and Feasibility Studies, 7 (1), [49].
(doi:10.1186/s40814-021-00784-5).
Abstract
Background: routine measurement of gastric residual volume (GRV) to guide feeding in neonatal and paediatric intensive care is widespread. However, this practice is not evidence based and may cause harm. As part of a feasibility study, we explored parent and practitioner views on the acceptability of a trial comparing GRV measurement or no GRV measurement.
Methods: a mixed-methods study involving interviews and focus groups with practitioners and interviews with parents with experience of tube feeding in neonatal and/or paediatric intensive care. A voting system recorded closed question responses during practitioner data collection, enabling the collection of quantitative and qualitative data. Data were analysed using thematic analysis and descriptive statistics.
Results: we interviewed 31 parents and nine practitioners and ran five practitioner focus groups (n=42). Participants described how the research question was logical, and the intervention would not be invasive and potential benefits of not withholding the child’s feeds. However, both groups held concerns about the potential risk of not measuring GRV, including delayed diagnosis of infection and gut problems, increased risk of vomiting into lungs and causing discomfort or pain. Parent’s views on GRV measurement and consent decision making were influenced by their views on the importance of feeding in the ICU, their child’s prognosis and associated comorbidities or complications.
Conclusions: the majority of parents and practitioners viewed the proposed trial as acceptable. Potential concerns and preferences were identified that will need careful consideration to inform the development of the proposed trial protocol and staff training.
Text
s40814-021-00784-5
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Accepted/In Press date: 26 January 2021
e-pub ahead of print date: 16 February 2021
Additional Information:
Funding Information:
This study was funded by the UK National Institute for Health Research Health Technology Assessment programme (16/94/02) and supported by the Medicines for Children Clinical Trials Unit. The study was sponsored by University Hospitals Bristol (UHB) NHS Foundation Trust.
Lyvonne Tume is an NIHR HTA panel member. Dr. Dorling reports grants from NIHR, during the conduct of the study for the study; grants from NIHR, and grants from Nutrinia, outside the submitted work. The grant from Nutrinia in 2018 was for part of his salary to work as an expert advisor on a trial. JD was a member of the NIHR HTA General Board (from 2017 to 2018) and the NIHR HTA Maternity, Newborn and Child Health Panel (from 2013 to 2018). Chris Gale is funded by the United Kingdom Medical Research Council (MRC) through a Clinician Scientist Fellowship award. He has received support from Chiesi Pharmaceuticals to attend an educational conference; in the past 5 years he has been investigator on received research grants from the Medical Research Council, National Institute of Health Research, Canadian Institute of Health Research, Department of Health in England, Mason Medical Research Foundation, Westminster Medical School Research Trust and Chiesi Pharmaceuticals. Frederic Valla has received consultant fees outside the scope of this study from Baxter and Nutricia.
Keywords:
Acceptability, Feasibility, Gastric residual volume, Intensive care
Identifiers
Local EPrints ID: 485006
URI: http://eprints.soton.ac.uk/id/eprint/485006
ISSN: 2055-5784
PURE UUID: ddd991b2-c398-441c-9b6c-5498f3907ec5
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Date deposited: 28 Nov 2023 17:34
Last modified: 18 Mar 2024 04:16
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Contributors
Author:
Elizabeth Deja
Author:
Louise Roper
Author:
Lyvonne N. Tume
Author:
Jon Dorling
Author:
Chris Gale
Author:
Barbara Arch
Author:
Lynne Latten
Author:
Nazima Pathan
Author:
Helen Eccleson
Author:
Helen Hickey
Author:
Jenny Preston
Author:
Anne Beissel
Author:
Izabela Andrzejewska
Author:
Frédéric V. Valla
Author:
Kerry Woolfall
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